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Biomedical subjects

Richard Shepherd

Publications and source records attributed to Richard Shepherd.

9 recordsLinked to original sources

Public responses to precautionary information from the Department of Health (UK) about possible health risks from mobile phones.

Understanding public perceptions of health information is of increasing importance in the light of the growing imperatives upon regulators to communicate information about risk and uncertainty. Communicating the possible health risks from mobile telecommunications is a domain that allows consideration of both public perceptions of uncertain public health information and public responses to precautionary advice. This research reports the results of a nationally representative survey in the UK (n=1742) that explored public responses to a leaflet issued by the Department of Health (DoH) in 2000 providing information about the possible health risks of mobile phones. The aims of the study were two-fold: (a) to assess awareness of the leaflet and the extent to which participants could identify the precautionary advice that the leaflet contained as coming from the Government; and (b) to examine publics' responses to the current Government precautionary advice about mobile phone health risks; was this associated with increased concern or reassurance? The results indicate the importance of policy makers developing a clear understanding of the possible effects of communicating precautionary advice.

Cell Phone↗

Prevalence of psychomorbidity among patients with chronic cough.

BACKGROUND: Chronic cough may cause significant emotional distress and although patients are not routinely assessed for co-existent psychomorbidity, a cough that is refractory to any treatment is sometimes suspected to be functional in origin. It is not known if patients with chronic cough referred for specialist evaluation have emotional impairment but failure to recognise this may influence treatment outcomes. In this cross-sectional study, levels of psychomorbidity were measured in patients referred to a specialist cough clinic. METHODS: Fifty-seven patients (40 female), mean age 47.5 (14.3) years referred for specialist evaluation of chronic cough (mean cough duration 69.2 (78.5) months) completed the Hospital Anxiety and Depression (HAD) scale, State Trait Anxiety Inventory (STAI) and the Crown Crisp Experiential Index (CCEI) at initial clinic presentation. Subjects then underwent a comprehensive diagnostic evaluation, after which they were classified as either treated cough (TC) or idiopathic cough (IC). Questionnaire scores were compared between TC (n = 42) and IC (n = 15). RESULTS: Using the HAD scale, 33% of all cough patients were identified as anxious, while 16% experienced depression. The STAI scores suggested moderate or high trait anxiety in 48% of all coughers. Trait anxiety was significantly higher among TC (p < 0.001) and IC patients (p = 0.004) compared to a healthy adult population. On the CCEI, mean scores on the phobic anxiety, somatisation, depression, and obsession subscales were significantly higher among all cough patients than the published mean scores for healthy controls. Only state anxiety was significantly higher in IC patients compared with TC patients (p < 0.05). CONCLUSION: Patients with chronic cough appear to have increased levels of emotional upset although psychological questionnaires do not readily distinguish between idiopathic coughers and those successfully treated.

Journal Article↗

Prevalence of obstructive lung disease in a general population sample: the NICECOPD study.

BACKGROUND: There are little data available on the prevalence of chronic obstructive pulmonary disease (COPD) in the United Kingdom. The Northern Ireland Cost and Epidemiology of Chronic Obstructive Pulmonary Disease (NICECOPD) study is a two-stage survey to examine the prevalence of obstructive lung disease in a general population sample in the Greater Belfast area. METHODS: In stage one 4000 subjects aged 40-69 years were selected at random from the general population. They were posted a short screening questionnaire concerning respiratory symptoms. Respondents were divided into 'symptomatic' and 'asymptomatic' groups according to their responses. In stage two, a sample of symptomatic and asymptomatic subjects completed a more intensive assessment that included a detailed questionnaire on medical history, spirometry, skin allergy testing and serial peak flow measurements. Spirometric criteria for airflow obstruction were FEV1/FVC ratio of <70% with FEV1 < 80% predicted. Subjects were assigned diagnoses according to a pre-arranged protocol. RESULTS: The survey was conducted from May 1999 to May 2001. There was a 67% response rate to the stage 1 screening questionnaire and 1330 responders were identified as being eligible to take part in stage 2. In total, 722 subjects completed a detailed assessment (50.8% Male, symptomatic, n = 326; asymptomatic, n = 396). COPD was diagnosed in 12.3% (8.8, 15.8) of the symptomatic and 2.2% (0.8, 3.6) of the asymptomatic group. The estimated prevalence of obstructive lung disease in the total population age 40-69 years was 14.4%: 6.3% COPD; 7.2% asthma; 0.9% with indeterminate airflow obstruction. In men, the prevalence of COPD varied from 4.9% in those aged 40-49 years to 12.3% in those aged 60-69 years and in women, varied from 1.4% in 40-49 years of age to 4.5% in 60-69 years. CONCLUSION: The data suggest that COPD and asthma are common conditions in the general population and should inform future plans to address the burden of disease.

Adult↗

Influences on food choice and dietary behavior.

There are a number of possible reasons for the lack of effectiveness of attempts at changing dietary behaviors. While lack of information and knowledge about foods and nutrient contents might play a part, motivation to change is likely to be much more important. Food choice, like any complex human behavior, is influenced by many interrelating factors, including various physiological, social and cultural factors, and these need to be taken into account when considering dietary interventions. In many cases people lack motivation to change. This can be related to optimistic bias, where people underestimate the risk to themselves relative to others from a variety of hazards. People feel less at risk personally for many dietary risks and this is related both to the control they feel they have over dietary behaviors and also to their considering themselves to have better diets than the average. The 'stages of change' model is a possible means for trying to address these motivational issues. While this model has been applied to various forms of behavior such as smoking, there are a number of problems transferring such a model from smoking to dietary behaviors, including the lack of clear cut specific behaviors and behavior change targets in the dietary field.

Attitude↗

Determinants of consumer behavior related to organic foods.

There have been many studies of what influences consumers in their decisions to purchase or consume organic foods, mainly concerned with fresh organic foods. These show a discrepancy between attitudes and behavior with people being positive about organic foods but often not purchasing them. This discrepancy seems to be explained by the fact that consumers do not consider "organically produced" to be an important purchase criterion, that organic foods are not perceived to surpass conventional foods regarding taste and shelf life (two qualities rated to be of great importance), and because of the perceived premium prices of organic foods. In two Swedish studies, health benefits were demonstrated to be more strongly related to attitudes and behavior toward organic foods than were perceived environmental benefits. A new European Union (EU) project will investigate the influences on both fresh and processed organic foods and investigate the role of moral, ethical, and affective influences on choice across eight EU countries.

Choice Behavior↗

Eating with your eyes: effect of appearance on expectations of liking.

It was hypothesised that consumers' expectations of liking for a food would be affected by its appearance both when raw and when cooked and that the impact of these expectations on actual liking for the product after eating would vary with consumer awareness of internal body states (private body consciousness). We found that consumers' expectations of liking for the food generated by the appearance of the cooked product was related to expectation of liking from viewing the raw product. Under some conditions, consumers liked a food less after consumption if a raw product that generated low expectation of liking had been presented beforehand. There was no evidence that private body consciousness modified the consumers' susceptibility to expectation effects. It was concluded that expectations of liking for a food generated by appearance both when raw and cooked influenced final evaluation of the product during consumption.

Animals↗

Moderating role of attitudinal ambivalence within the theory of planned behaviour.

The present study examined the moderating role of attitudinal ambivalence within the theory of planned behaviour (TPB). Attitude, subjective norm, perceived behavioural control (PBC), behavioural intentions and self-reported behaviour were assessed in relation to 20 healthy eating behaviours in a prospective questionnaire design in 232 members of the general public in the UK. Between-participants univariate and multivariate analyses indicated attitude-behaviour and PBC-behaviour relationships to be weaker in higher ambivalence compared to lower ambivalence respondents. These effects were confirmed in within-participants analyses. The findings are discussed in terms of the role of ambivalence in furthering our understanding of relationships in the TPB.

Adult↗

Resistance to changes in diet.

Dietary changes can be difficult to effect both at an individual and at a population level, and even when changes do occur they are often far slower and less pronounced than might be expected. Three possible reasons for this situation will be considered: the complexity of food choice and competing influences, attitudinal ambivalence and optimistic bias. Food choice is influenced by a large number of factors, not only health considerations, and therefore it is not surprising that interventions based primarily on health concerns have been ineffective. Another concern is that people do not always have clear-cut attitudes, but rather can be ambivalent about foods and about healthy eating, and this factor might impact on the translation of beliefs and attitudes into behaviour. A third possible reason is optimistic bias, where individuals believe themselves to be at less risk from various hazards than is the average person. This effect has been demonstrated for nutritional risks, and this factor might lead people to take less note of health education messages. The stages-of-change model from health psychology has been proposed as a method for improving the effectiveness of behaviour change interventions. However, there are a number of problems in transferring such a model from smoking, where it was originally developed, to dietary behaviours, including the lack of clear-cut specific behaviours and behaviour change targets in the dietary field.

Attitude↗